Factors predicting the onset of adolescent drinking in families at high risk for developing alcoholism

Background: With a longitudinal prospective design, the purpose of this stu dy was 1) to assess, with survival analysis, the age of onset of drinking i n relation to family history of alcoholism; 2) to examine the importance of selected neurobiological and psychosocial risk factors in predicting the o nset to drink; and 3) to determine if the age of onset of substance depende nce problems differed by risk group status. Methods: One hundred twenty-five children and adolescents were evaluated an nually (N = 638 evaluations), providing up to seven annual waves of longitu dinal data, Survival analyses were performed to determine the age of onset of regular drinking and the age of onset for substance abuse/dependence. Th e age of onset of regular drinking outcome was modeled using familial densi ty of alcoholism and four factors, which included neurobiological indices o f development (postural sway and P300), personality characteristics, academ ic achievement, self-esteem, and trait anxiety. Results: High-risk children/adolescents showed a significantly earlier age of onset of drinking and an earlier age of onset for substance abuse proble ms. Familial density of alcoholism predicted an earlier onset of drinking, as did having deficits in reading achievement, reduced P300 (visual and aud itory), and greater postural sway for age. Higher scores on the Extraversio n scale of the Junior version of the Eysenck Personality Inventory also pre dicted an earlier onset of drinking. Conclusions: Familial density of alcoholism (number of alcoholic first- and second-degree relatives) is an important predictor of adolescent alcohol i nitiation, Evidence is presented suggesting that part of the familial/genet ic variation in outcome may be due to neurobiological factors and temperame nt, (C) 2000 Society of Biological Psychiatry.